[Pyoderma gangrenosum: a rare pathology or an omitted diagnosis?]

Area of Science:

• Dermatology
• Pathology

Background:

• Pyoderma gangrenosum (PG) is a rare inflammatory dermatosis of uncertain etiology.
• It is characterized by rapidly evolving cutaneous necrosis.
• PG is a diagnosis of exclusion due to lack of precise diagnostic criteria.

Observation:

• Pathergy, a phenomenon where PG lesions worsen after nonspecific external stimuli like trauma or surgery, occurs in 40-50% of cases.
• Surgical excision of PG lesions can lead to worsening of the condition.
• Delayed or missed diagnosis often forces surgeons to debride wounds, exacerbating the necrosis.

Findings:

• The presented cases highlight the challenges in diagnosing and managing pyoderma gangrenosum.
• The study emphasizes the critical importance of recognizing pathergy to guide treatment decisions.
• Improper surgical intervention can lead to severe and detrimental consequences for patients.

Implications:

• Accurate and timely diagnosis of pyoderma gangrenosum is crucial to avoid detrimental surgical interventions.
• Understanding the pathergy phenomenon is vital for clinicians to prevent iatrogenic worsening of lesions.
• These case reports underscore the need for increased awareness and improved diagnostic strategies for this rare condition.